Laparoscopic clipping machine for application of surgical clips on tissue structures

Abstract

A laparoscopic clipping machine that is used to apply clips on tissue structures is enclosed in a housing and includes a pair of movable jaws mounted on a stem. Operational movement for clamping the clips is indirectly triggered by a movement of the handle. The clipping machine further includes at least one spring and a mechanism directly triggering the operational movement of the jaws having at least one pusher movably arranged in the axis of the stem supported in the axis of the stem on the spring. An adjustment mechanism adjusts the jaws output opening to at least two different positions adapted to at least two sizes of the clips, resulting in a different output angle between the jaws, wherein the adjustment mechanism includes a movable shutter element having at least two parts, the narrower part of the shutter element and the wider part of the shutter element.

The invention claimed is: 
     
       1. A laparoscopic clipping machine for application of clips on tissue structures, enclosed in a housing, comprising:
 a pair of movable jaws mounted on a stem, whose operational movement for clamping the clips is indirectly triggered by movement of a handle, 
 at least one spring, 
 a mechanism directly triggering operational movement of the jaws including at least one pusher movably arranged along an axis of the stem supported in the axis of the stem on the at least one spring, 
 an adjustment mechanism that adjusts the jaws output opening to at least two positions of the output opening adapted to receive at least two sizes of the clips, resulting in an output angle between the jaws, the adjustment mechanism including:
 a movable shutter element having at least two parts, including a narrower part of the shutter element and a wider part of the shutter element, and the shutter element is movably guided through a through opening laterally formed in the at least one pusher, wherein the through opening is larger than the wider part of the shutter element such that the shutter element, when seated in the through opening, partially covers the through opening, thus limiting the movement of the at least one pusher when determining the output angle, in such a way, that when the narrower part of the shutter element is positioned within the through opening, a partially limited longitudinal movement of the at least one pusher is obtained, resulting in a first output angle, and when the wider part of the shutter element is positioned within the through opening, a further limited longitudinal movement of the at least one pusher is obtained, resulting in the second output angle. 
 
 
     
     
       2. The clipping machine according to  claim 1 , wherein:
 the through opening is oval in the longitudinal cross-section, 
 the oval has a shorter diameter and a longer diameter, and 
 the longer diameter of the oval is directed along the axis of the at least one pusher and the shorter diameter of the oval is perpendicular to the at least one pusher axis and the longer diameter of the oval is longer than the widest part of the shutter element. 
 
     
     
       3. The clipping machine according to  claim 2 , wherein:
 the movable shutter element comprises a first cylinder extending on one side into a cone with a diameter increasing in relation to the diameter of a second cylinder and further extending into the second cylinder, wherein the second cylinder is partly guided in a first sleeve of the stem, and 
 a threaded connection is formed on the lateral surface of the second cylinder extending through the first sleeve and on the inner surface of the first sleeve such that the shutter element is screwed into the first sleeve by passing through the through opening, in such a way, that the second cylinder is screwed into the first sleeve passing through the through opening, such that, when the first cylinder passes through the through opening, the partially limited longitudinal movement of the at least one pusher is obtained, resulting in the first output angle, when the second cylinder is screwed into the first sleeve and positioned through the through opening, the further limited longitudinal movement of the at least one pusher is obtained, resulting in the second output angle, and when the cone is positioned within the through opening, the output angle is a value between the first output angle and second output angle. 
 
     
     
       4. The clipping machine according to  claim 3 , wherein the at least one pusher comprises:
 at least two movably connected pushers connected to each other, the first pusher positioned at the top of the handle and the second pusher extending into the stem, wherein:
 one end of the first pusher has a spherical seat and one end of the second pusher has a sphere matching the seat such that the sphere is connected to the seat, and at the connection of the first and second pushers there is a rotational mechanism configured to cause a rotation of the second pusher and the stem relative to the first pusher, wherein the rotational mechanism comprises a knob and a second sleeve connected to the stem. 
 
 
     
     
       5. The clipping machine according to  claim 2 , wherein the at least one pusher comprises:
 at least two movably connected pushers connected to each other, the first pusher positioned at the top of the handle and the second pusher extending into the stem, wherein:
 one end of the first pusher has a spherical seat and one end of the second pusher has a sphere matching the seat such that the sphere is connected to the seat, and at the connection of the first and second pushers there is a rotational mechanism configured to cause a rotation of the second pusher and the stem relative to the first pusher, wherein the rotational mechanism comprises a knob and a second sleeve connected to the stem. 
 
 
     
     
       6. The clipping machine according to  claim 1 , wherein:
 the movable shutter element comprises a third cylinder connected to a fourth cylinder with a larger diameter relative to the third cylinder, 
 wherein the fourth cylinder is movably arranged in a first sleeve of the stem, and 
 a threaded connection is formed on the lateral surface of the fourth cylinder extending through the first sleeve and on the inner surface of the first sleeve, such that a part of the fourth cylinder is screwed into the first sleeve passing through the through opening, such that, when the third cylinder is positioned within the through opening, the partially limited longitudinal movement of the at least one pusher is obtained, resulting in the first output angle, and when the part of the fourth cylinder is screwed into the first sleeve and positioned within the through opening, further limited longitudinal movement of at least one pusher is obtained, resulting in the output second angle. 
 
     
     
       7. The clipping machine according to  claim 6 , wherein the at least one pusher comprises:
 at least two movably connected pushers connected to each other, the first pusher positioned at the top of the handle and the second pusher extending into the stem, wherein:
 one end of the first pusher has a spherical seat and one end of the second pusher has a sphere matching the seat such that the sphere is connected to the seat, and at the connection of the first and second pushers there is a rotational mechanism configured to cause a rotation of the second pusher and the stem relative to the first pusher, wherein the rotational mechanism comprises a knob and a second sleeve connected to the stem. 
 
 
     
     
       8. The clipping machine according to  claim 1 , wherein:
 the movable shutter element comprises a gripping part mounted on the clipping machine housing and a shutter part permanently connected to the gripping part wherein the shutter part passes through the through opening, and 
 wherein the shutter part has the shape of a cam with a width and a height, wherein the shutter part is movably guided, by means of the gripping part, into the through opening, such that, when the shutter part is positioned within and through opening in such a way that the width of the shutter part covers the through opening, the partially limited longitudinal movement of the at least one pusher is obtained, resulting in the first output angle, and when the shutter element is rotated using the gripping part such that the height of the shutter part covers the through opening, the further limited longitudinal movement of the at least one pusher is obtained, resulting in the second output angle. 
 
     
     
       9. The clipping machine according to  claim 8 , wherein the at least one pusher comprises:
 at least two movably connected pushers connected to each other, the first pusher positioned at the top of the handle and the second pusher extending into the stem, wherein:
 one end of the first pusher has a spherical seat and one end of the second pusher has a sphere matching the seat such that the sphere is connected to the seat, and at the connection of the first and second pushers there is a rotational mechanism configured to cause a rotation of the second pusher and the stem relative to the first pusher, wherein the rotational mechanism comprises a knob and a second sleeve connected to the stem. 
 
 
     
     
       10. The clipping machine according to  claim 1 , wherein the at least one pusher comprises:
 at least two movably connected pushers connected to each other, the first pusher positioned at the top of the handle and the second pusher extending into the stem, wherein:
 one end of the first pusher has a spherical seat and one end of the second pusher has a sphere matching the seat such that the sphere is connected to the seat, and at the connection of the first and second pushers there is a rotational mechanism configured to cause a rotation of the second pusher and the stem relative to the first pusher, wherein the rotational mechanism comprises a knob and a second sleeve connected to the stem. 
 
 
     
     
       11. The clipping machine according to  claim 1 , wherein:
 the movable shutter element comprises the first cylinder extending on one side into cone with a diameter increasing in relation to the diameter of the second cylinder and further extending into the second cylinder, wherein the second cylinder is partly guided in the first sleeve of the stem, and 
 a threaded connection is formed on the lateral surface of the second cylinder extending through the first sleeve and on the inner surface of the first sleeve such that the shutter element is screwed into the first sleeve by passing through the through opening, in such a way, that the second cylinder is screwed into the first sleeve passing through the through opening, such that, when the first cylinder passes through the through opening, the partially limited longitudinal movement of the at least one pusher is obtained, resulting in the first output angle, when the second cylinder is screwed into the first sleeve and positioned through the through opening, the further limited longitudinal movement of the at least one pusher is obtained, resulting in the second output angle, and when the cone is positioned within the through opening, the output angle is a value between the first output angle and second output angle. 
 
     
     
       12. The clipping machine according to  claim 11 , wherein the at least one pusher comprises:
 at least two movably connected pushers connected to each other, the first pusher positioned at the top of the handle and the second pusher extending into the stem, wherein:
 one end of the first pusher has a spherical seat and one end of the second pusher has a sphere matching the seat such that the sphere is connected to the seat, and at the connection of the first and second pushers there is a rotational mechanism configured to cause a rotation of the second pusher and the stem relative to the first pusher, wherein the rotational mechanism comprises a knob and a second sleeve connected to the stem. 
 
 
     
     
       13. The clipping machine according to  claim 12 , wherein:
 the movable shutter element comprises a third cylinder connected to the fourth cylinder with a larger diameter relative to the third cylinder, 
 wherein the fourth cylinder is movably arranged in the first sleeve of the stem, and 
 a threaded connection is formed on the lateral surface of the fourth cylinder extending through the first sleeve and on the inner surface of the first sleeve, such that a part of the fourth cylinder is screwed into the first sleeve passing through the through opening, such that, when the third cylinder is positioned within the through opening, the partially limited longitudinal movement of the at least one pusher is obtained, resulting in the first output angle, and when the part of the fourth cylinder is screwed into the first sleeve positioned within the through opening, further limited longitudinal movement of the at least one pusher is obtained, resulting in the output second angle. 
 
     
     
       14. The clipping machine according to  claim 13 , wherein the at least one pusher comprises:
 at least two movably connected pushers connected to each other, the first pusher positioned at the top of the handle and the second pusher extending into the stem, wherein:
 one end of the first pusher has a spherical seat and one end of the second pusher has a sphere matching the seat such that the sphere is connected to the seat, and at the connection of the first and second pushers there is a rotational mechanism configured to cause a rotation of the second pusher and the stem relative to the first pusher, wherein the rotational mechanism comprises a knob and a second sleeve connected to the stem.